Provider Demographics
NPI:1396128153
Name:LOAFMAN, KERRI A (BCBA)
Entity type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:A
Last Name:LOAFMAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5020 CLARK RD # 123
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-3231
Mailing Address - Country:US
Mailing Address - Phone:850-699-6627
Mailing Address - Fax:877-772-3402
Practice Address - Street 1:5020 CLARK RD # 123
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-3231
Practice Address - Country:US
Practice Address - Phone:850-699-6627
Practice Address - Fax:877-772-3402
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst